THU0416 PREDICTORS OF RADIOGRAPHIC PROGRESSION IN HAND OSTEOARTHRITIS: A TEN-YEARS PROSPECTIVE COHORT STUDY

Abstract

Background Osteoarthritis (OA) is the most common musculoskeletal disease in the general population and is inherent to ageing.1 Limited evidence is available on risk factors for radiographic progression in hand OA (HOA) and in erosive HOA.2 A previous evaluation of the Ghent HOA cohort showed a positive association between soft tissue swelling, tenderness upon pressure and pain with radiographic progression.3 Objectives To identify new prognostic factors and to confirm existing evidence on already identified prognostic factors for radiographic progression in HOA. Methods All 270 patients from this cohort were contacted to participate in a second follow-up visit after ten years at the Ghent University Hospital. A total of 106 patients consented to this follow-up visit. Presence of tender and swollen joints was assessed. Grip strength was measured. Functional Index for HOA (FIHOA) and Australian/Canadian OA Index questionnaires (AUSCAN) were completed by the patients. Pain was scored on a visual analogue scale from 0-100mm (VAS pain). Radiographs of hands were taken and scored using the anatomical phase scoring system for HOA by Verbruggen and Veys4. Patients were defined as radiographic progressor when two or more joints progressed to another phase within the scoring system, except for N-phase to S-phase. Logistic regression was performed on the clinical data and outcomes such as presence of tenderness (yes or no), soft tissue swelling (yes or no), VAS pain, disease duration, FIHOA and AUSCAN. VAS pain was dichotomized into two groups: VAS ≤33mm and VAS >33mm. Disease duration was dichotomized in ≤5 years and >5 years: p-values and odds ratios (OR) with 95% confidence intervals (95% CI) were calculated. Results After a mean follow-up of 9.7 years, 73.3% of the patients showed radiographic progression. The following clinical factors were associated with radiographic progression on patient level (OR [95%CI]): presence of tenderness (4.19 [1.52-11.61]), presence of soft tissue swelling (2.73 [1.08-6.92]) and disease duration > five years (4.00 [1.50-10.66]). Other outcomes were retained as prognostic factors for radiographic progression (OR [95%CI]): VAS pain (1.02 [1.00-1.04]), total FIHOA (1.12 [1.03-1.23]), total AUSCAN (1.02 [1.01-1.04], AUSCAN pain (1.07 [1.02-1.12], AUSCAN function (1.03 [1.01-1.06]) and VAS pain > 33mm (2.87 [1.14-7.24]). The mean number of E and R joints was 1.2 and 1.4 at baseline, and 0.2 and 5.2 after 10 years (p Conclusion Clinical presence of pain and soft tissue swelling at baseline remain strong predictors of radiographic progression in HOA after ten years. Tenderness upon pressure, moderate VAS pain and moderate impaired function at baseline are identified as new predictors. After ten years, more remodeling and less erosive joints are seen.